Hematology
A 9-year-old child with leukemia is scheduled to undergo an allogeneic hematopoietic stem cell transplant. When teaching the child and parents, what information would the nurse include? A. "We'll need to have a match to a donor" B. "The risk for rejection is much less with this type of transplant" C. "You won't need to receive the high dose of chemotherapy before the transplant" D/ "you'll need to have an incision in your hip area to instill the cells."
A. "We'll need to have a match to a donor" - the donor must be a close match to the patient in order to reduce chance of rejection and graft-versus-host disease.
A patient comes to the clinic reporting fatigue and pica. Laboratory findings reveal a low serum iron level and a low ferritin level. Upon evaluation of this assessment and laboratory data, the nurse suspects that the patient will be diagnosed with: A. iron-deficiency anemia B. pernicious anemia C. sickle cell anemia D. hemolytic anemia
A. Iron-deficiency anemia - Low serum iron is the hallmark of iron-deficiency anemia - pernicious anemia would be a lack of B12 vitamin - sickle cell anemia is a disease of itself - hemolytic anemia is due to lysing of RBC
A client presents to the clinic with symptoms of elevated blood pressure, dizziness, red face, pain in fingers and toes, headache, and difficulty concentrating. A blood smear reveals an increased number of erythrocytes. Based on these findings, the nurse anticipates which diagnosis? A. Polycythemia vera B. Leukemia C. Hemolytic anemia D. Hyperbilirubinemia
A. Polycythemia vera - Polycythemia vera is a neoplastic disease of the pluripotent cells of the bone marrow characterized by an absolute increase in total red blood cell mass accompanied by elevated white cell and platelet counts. - Clinical manifestations are hypertension, headache, dizziness, inability to concentrate, and some difficulty with hearing and vision because of decreased cerebral blood flow.
A couple is expecting a child. The fetus undergoes genetic testing and the couple discover the fetus has sickle cell disease. The couple ask the nurse how most commonly happens. Which statement is accurate for the nurse to provide? A. Sickle cell disease occurs form a random genetic mutation B. Sickle cell disease is passed to a fetus when both parents have the gene. C. Sickle cell disease is passed to a fetus when one of the patents has the gene. D. Sickle cell disease can be passed to the fetus in many ways. We will know more at birth.
B. Sickle cell disease is passed to a fetus when both parents have the gene. - Sickle cell is an autosomal recessive gene, requiring both parents to pass the gene to the fetus.
A client diagnosed with polycythemia vera has come into the clinic because he has developed a nighttime cough, fatigue, and shortness of breath. What complication would you suspect in this client? A. Stroke B. Tissue infarction C. Congestive heart failure D. pulmonary embolus
C. Congestive heart failure - The symptoms exhibited by this client are indicative of congestive heart failure. Complications include hypertension, congestive heart failure, stroke, tissue and organ infarction, and hemorrhage. - Stroke would present with headache, aphasia, and/or numbness in extremities. -Tissue infarction would involve extremity discoloration or an organ failure. - Pulmonary embolism would be associated with chest pain.
The nurse is teaching the parents of a 15-year-old boy who is being treated for acute myeloid leukemia about the side effects of chemotherapy. For which symptoms should the parents seek medical care immediately? A. earache, stiff neck, or sore throat B blisters, ulcers, or a rash appears C. temperature of 101 F or greater D. difficulty or pain when swallowing
C. temperature of 101 F or greater - Temp over 101 is a sign of infection, a bad condition when you immunocompromised due to chemotherapy. - The appearance of earache, stiff neck, sore throat, blisters, ulcers, or rashes (or difficulty/pain when swallowing) are reasons to seek medical care, but are not as grave as the risk of infection.
A clinic nurse is working with a client who has a long-standing diagnosis of polycythemia vera. How can the nurse best gauge the course of the client's disease? A. Document the color of the client's palms and face during each visit B. Follow the client's ESR over time C. Document the client's response to erythropoietin injections D. Follow the trends of the client's hematocrit
D. Follow the trends of the client's hematocrit - The course of polycythemia vera can be best ascertained by monitoring the client's hematocrit, which should remain below 45%. - Erythropoietin injections would exacerbate the condition. - Skin tone should be observed, but is a subjective assessment finding. - The client's erythrocyte sedimentation rate is not relevant to the course of the disease.
